We are looking for experienced Prior Authorization Associates to join our team. The candidate will be responsible for obtaining prior authorizations from insurance companies for medical procedures, services, and medications to ensure timely patient care and accurate billing.
Key Responsibilities:
Handle end-to-end Prior Authorization processes for medical services.
Verify patient insurance eligibility and benefits.
Initiate and follow up on authorization requests with insurance providers.
Coordinate with physicians, clinics, and internal teams for required documentation.
Track authorization status and ensure timely approvals.
Maintain accurate records in the system and update authorization details.
Ensure compliance with payer guidelines and client requirements.
Work on denials and re-submissions if required.
Required Skills:
Good understanding of US Healthcare – Prior Authorization process.
Strong communication and analytical skills.
Ability to work on multiple payer portals and EMR systems.
Attention to detail and ability to meet turnaround time (TAT).
Basic knowledge of medical terminologies and insurance guidelines.
Eligibility Criteria:
1–5 years of experience in Prior Authorization.
Cardiology specialty experience is highly preferred.
Immediate joiners will be an added advantage.
